• Journal of Preventive Medicine and Public Health
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• 제39권2호
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• pp.115-122
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• 2006

Objectives : This study was conducted to examine the relationships of the several socioeconomic position indicators with the mortality risk in a representative longitudinal study of South Korea. Methods : The 1998 National Health and Nutrition Examination Survey was conducted on a cross-sectional probability sample of South Korean households, and it contained unique 13-digit personal identification numbers that were linked to the data on mortality from the National Statistical Office of Korea. Of 5,607 males and females, 264 died between 1999 and 2003. Cox's regression was used to estimate the relative risks (RR) and their 95% confidence intervals (CI) of mortality. Results: Socioeconomic differences in mortality were observed after adjustments were made for gender and age. Compared with those people having college or higher education, those people without any formal education had a greater mortality risk (RR=2.21, 95% CI=1.12-4.40). The mortality risk among manual workers was significantly greater than that for the non-manual workers (RR=2.73, 95% CI=1.47-5.06). A non-standard employment status was also associated with an increase in mortality: temporary or daily workers had a greater mortality risk than did the full-time workers (RR=3.01, 95% CI=1.50-6.03). The mortality risk for the low occupational class was 3.06 times greater than that of the high and middle occupational classes (95% CI=1.75-5.36). In addition, graded mortality differences according to equivalized monthly household income were found. A reduction of monthly household income by 500 thousand Korean Won (about 400 US dollars) was related with a 20% excess risk of mortality. Self-reported poor living standards were also associated with an increased risk of mortality. Those without health insurance had a 3.63 times greater risk of mortality than the insured (95% CI=1.61-8.19). Conclusions: This study showed the socioeconomic differentials in mortality in a national longitudinal study of South Korea. The existence of socioeconomic mortality inequalities requires increased social discussion on social policies in Korean society. Furthermore, the mechanisms for the socioeconomic inequalities of mortality need to be explored in future studies.

• Journal of Preventive Medicine and Public Health
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• 제38권3호
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• pp.337-344
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• 2005

Objectives : Job insecurity, such as non-standard work, is reported to have an adverse impact on health, regardless of health behaviors. The aim of this study was to examine the relationship between non-standard employment and health in Korea. Methods : We analyzed a representative weighted sample, which consisted of 2,112 men and 1,237 women, aged 15-64, from the 1998 Korea National Health and Nutrition Examination Survey. Non-standard employment included part-time permanent, short time temporary and daily workers. Self-reported health was used as a health indicator. Results : This study indicated that women were more likely to report poorer health than men with standard jobs. Of all employees, 20.3% were female manual workers. After adjusting for potential confounders, such as age, education, equivalent income, marital, social and self-reported economic status and health behavior factors, nonstandard employment was found to be significantly associated with poor health among female manual workers (OR, 1.86; 95% CI, 1.24 to 2.79). No significant association was found in other working groups Conclusions : Among female manual workers, nonstandard employees reported significantly poorer health compared with standard workers. This result raises concern as there are increasing numbers of non-standard workers, particularly females.

• Nutrition Research and Practice
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• 제14권4호
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• pp.384-400
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• 2020

BACKGROUND/OBJECTIVES: Dietary factors are important contributors to cardiometabolic and cancer mortality. We examined the secular trends of nine dietary factors (fruits, vegetables, whole grains, nuts and seeds, milk, red meat, processed meat, sugar-sweetened beverages, and calcium) and the associated burdens of cardiometabolic and cancer mortality in Korea using representative cross-sectional survey data from 1998 to 2016. SUBJECTS/METHODS: Using dietary data from Korean adults aged ≥ 25 years in the Korea National Health and Nutrition Examination Survey (KNHANES), we characterized secular trends in intake levels. We performed comparative risk assessment to estimate the population attributable fraction and the number of cardiometabolic and cancer deaths attributable to each dietary factor. RESULTS: A total of 231,148 cardiometabolic and cancer deaths were attributable to nine dietary risk factors in Korea from 1998 to 2016. Suboptimal intakes of fruits and whole grains were the leading contributors. Although the intakes of fruits, vegetables, and whole grains moderately improved over time, the intake levels in 2016 (192.1 g/d, 225.6 g/d, and 10.9 g/d, respectively) remained far below the optimal levels. Deaths attributable to the low intakes of nuts and seeds (4.5 g/d), calcium (440.5 mg/d), and milk (37.1 g/d) and the high intakes of red meat (54.7 g/d), processed meat (4.7 g/d), and sugar-sweetened beverages (33.0 g/d) increased since 1998. Compared with older age groups (≥ 45 years), more unfavorable changes in dietary patterns were observed in the younger population aged 25-44 years, including more sharply increased intakes of processed meat. CONCLUSIONS: We observed improvement in the intakes of fruits, vegetables, and whole grains and unfavorable changes in the intakes of processed meat and sugar-sweetened beverages over the past few decades. Our data suggest that to reduce the chronic disease burden in Korea, more effective nutritional policies and interventions are needed to target these dietary risk factors.

• 보건교육건강증진학회지
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• 제28권1호
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• pp.93-101
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• 2011

Objectives: The aim of this study was to investigate the prevalence of metabolically obese, normal-weight (MONW) phenotype and the association between lifestyle factors and the risk of MONW in Korean adolescents. Methods: Normal-weight (BMI, 5th to 85th percentile) subjects with ${\geq}1$ metabolic abnormalities were categorized as MONW phenotype. Data from adolescents aged 12 to 18 years who have participated in the Korean National Health and Nutrition Examination Survey in 1998 (n=751) and 2008 (n=455) were analyzed. Physical activity and dietary intakes were assessed. Results: The prevalence of hypertension and hyperglycemia in 2008 decreased compared with that in 1998 (P<0.001) but the prevalence of abdominal obesity, hypertriglyceridemia and low HDL did not changed. The overall prevalence of MONW in Korean adolescents declined over 10 years (P<0.001). Adolescent boys and girls engaging regular exercise significantly increased over 10 years (P<0.01). Physically active adolescents had a lower risk of being MONW in 1998. Dietary intake patterns were not associated with a risk of MONW. Conclusions: The prevalence of MONW among Korean adolescents declined over 10 years which may be due to the decreased prevalence of hypertension and hyperglycemia. The risk of MONW would be lower in individuals who are physically active.

• 보건교육건강증진학회지
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• 제18권3호
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• pp.11-36
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• 2001

The purpose of this study is to analyze health behavior by comparing the difference between self-perceived health status and health examination results. The study subjects consist of 7,702 people aged over 20, surveyed by Health Interview survey, Health Examination survey, Dietary Life survey, Health Consciousness and Behavior survey. Data used in the study are drawn from raw data from a 1998 National Health and Nutrition survey. General characteristics variables are sex, age, education level, residential area, marital status, occupation, and living standard while dichotomous variables, ‘not healthy’ and ‘healthy’ are used to measure self-perceived health status. Variables for health examination results are high blood pressure, high cholesterol, diabetes, liver diseases, liver inflammation, kidney diseases, normal weight, regular diet, optimum sleeping time(7-8 hours), regular health examination and health behavior practice group. Major findings of the study are as follows: 1) Analysis of self-perceived health status and health behavior by disease: Variables significantly correlated with high self-perceived health status have strong associations with high health behavior practice, which supports the hypothesis that as one has high self-perceived health status, one is more likely to practice health promoting behavior. The results of analysis of health behavior differences by dividing subjects into two categories, ‘cases of illness’ and ‘cases of no illness’ indicate that drinking, sleeping time, health examination are significant variables (p〈0.001, 0.05) whereas smoking, weight control, regular exercise, regular diet are not significant. 2) Analysis of disparity patterns between self-perceived health status and health examination: The hypothesis that health behaviors would be different according to the disparity pattern between self-perceived health status and health examination is supported as a result of χ2 test. Among Type I : Self-perceived health status is high and actual health status is good (no disease) Type II: Self-perceived health status is high and actual health status is poor(have disease) Type III: Self-perceived health status is low and actual health status is good(no disease) Type IN: Self-perceived health status is low and actual health status is poor(have disease) Type I and Type IV show no disparity, Type I shows the highest health promoting behavior whereas Type IV shows the lowest health promoting behavior. Type II, and III, compared to Type I, practise lower health promoting behavior. Multi-logistics regression analysis was conducted to find out the degree of impact on health behavior. Independent variables are general characteristics, self-perceived health status and health examination result and presence of illness, while the dependent variable is health promoting behavior. The analysis of the impact of self-perceived health status on the health promoting behavior shows that smoking, drinking, weight control, regular exercise, health examination practice, and/or regular diet are significantly correlated to self-perceived health status. High self-perceived health status is inversely related to high health promoting behavior. This finding supports the hypothesis that the higher one perceives one's health, the more likely one is to practice health promoting behavior. On the contrary, the presence of illness has little impact on health promoting behavior. 3) Multiple logistics analysis on how disparity patterns between self-perceived health status and health examination affect health behavior: The results of multiple logistics analysis made on health behavior variables compared to the standard variable are as follows: When analyzed on the standard of Type I, smoking is a significant risk factor for the Type IV. In case of drinking, all the patterns show a high probability of relative risk ratio. With regard to weight control, it is a risk factor for Type II while all the patterns show high probability of not practising when analyzed on the standard of type IV. Type III and IV show high probability of not doing regular exercise while Type IV, shows a high probability of not taking appropriate sleeping time. When analyzed on the standard of type IV, all the patterns show a high probability of not taking health examinations. Type III and IV show a high probability of not having regular meals. As for overall health promoting behavior, Type III and IV show a high relative risk ratio. These two groups have low self-perceived health status. It implies that self-perceived health status has significant impact on health promoting behavior. This is also supported by the fact that Type I with high self-perceived health status and no illness shows a high practice rate of health promoting behavior. Types II and III the groups with high disparity between self-perceived health status and health examination results, show a low practice rate of health promoting behavior when compared to Type I. Type IV, that is the group with low self-perceived health status and actual illness, shows the lowest practice of health promoting behavior. It is highly probable that this type proves to be the poorest health group.

• 동아시아식생활학회지
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• 제22권2호
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• pp.147-162
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• 2012

Abdominal obesity is an important factor of metabolic syndrome and is known as an independent risk factor of cardiovascular disease. The purpose of this study was to examine the fatty acid intake pattern as well as the association between fatty acid intake and abdominal obesity and hyperglycemia in Korean adults. This study was based on data from the Korea National Health and Nutrition Examination Surveys (KNHANES) I, II, III, and IV. After excluding subjects who had missing data for dietary intakes, anthropometric measurments, and laboratory tests, a total of 12,320 subjects aged 20~64y (5,266 men and 7,054 women) were included in the study. Trends in individual consumption of dietary fatty acids by year were analyzed by One-way ANOVA test, and the association between fatty acid intake and abdominal obesity and hyperglycemia was analyzed by logistic regression analysis after adjusting for age, energy intake, marital status, job, education level, alcohol intake, and smoking status. In men, intakes of TFA, SFA, MUFA, FUFA, and n-6 PUFA significantly increased with year. On the other hand, intakes of TFA, SFA and FUFA significantly increased with year in women. Logistic regression analysis showed that the risk of abdominal obesity was significantly associated with intakes of PUFA, LNA and n-3 PUFA in women. However, there was no association with any fatty acid intakes in men. The risk of hyperglycemia was significantly and positively associated with intakes of TFA, SFA, PUFA, and LNA in men, but, there was no significant association with any fatty acid intakes in women. These results show that abdominal obesity and hyperglycemia are significantly associated with individual intake of fatty acids, suggesting that fatty acid type may be associated with risk of abdominal obesity and hyperglycemia. Futher, the macronutrients of measl must be properly balanced.

• 한국학교보건학회지
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• 제22권2호
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• pp.25-36
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• 2009

Purpose: The purpose of this study was to estimate income-related health inequalities among adolescent population across regions in Korea. Methods: Data of 8,456 adolescents from 1998, 2001, 2005, 2007 Korean Health and Nutrition Examination Survey were used for the analysis. True health status was proxied by self-rated health and overweight status. Per capita income was computed from household monthly average income adjusted by consumer price with base year 2005. Adolescent health inequalities were estimated by Concentration Index (CI) across income and space. Results: Ill health score was related with age (p<0.0001), gender (p=0.0155) and income (p<0.0001). Negative relationship between income and ill-health indicated that higher income group tended to enjoy better health and less overweight. These evidences suggested ill health were accumulated on the economically disadvantaged adolescents. The size of health inequalities (ill-health score) were estimated as CI=-0.057 and CI=-0.030 across income groups and regions, respectively. Comparable measures of within region health disparities were also observed. Conclusion: Since health disparity among adolescent population was small compared to adult population, lessening adolescent health inequality could be a helpful way of mitigating health disparities in later stage. Considering life stage of adolescents, school system and local communities could play important roles toward adolescent health distribution. Although health disparity between regions existed, health disparity within a region should not be neglected.

• Journal of Nutrition and Health
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• 제52권2호
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• pp.206-216
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• 2019

본 연구는 당뇨병 환자들의 소득수준에 따라 대사위험지표 관리수준을 비교하고, 최근 관리 추이를 관찰하여 궁극적으로 당뇨병 환자들의 합병증 예방 관련 전략을 마련할 수 있는 기초자료를 마련하기 위하여 1998 ~ 2014년 국민건강영양조사 자료를 분석하였다. 국민건강영양조사에 참여한 조사대상자 중 당뇨병 환자이면서 본인의 질환을 인지하고 있는 대상자들을 추출하였고, 가구소득정보를 이용하여 세 그룹으로 분류하여 분석하였다. 당뇨병 환자들의 기본정보, 생활습관정보, 영양소 섭취 정보, 혈액지표 등은 건강설문조사, 영양조사, 검진조사를 통해 수집되었다. 자료 분석은 변수 특성에 따라 카이검정, 일원분산분석 등을 실시하였고, 다중선형회귀분석을 이용하여 혈압 및 혈액지표의 보정평균을 산출하였다. 당뇨환자들의 공복혈당, HbA1c 및 혈중지질 농도의 평균은 소득수준에 따라 유의적인 차이를 보이지 않았다. 조사기간인 1998년부터 2014년간의 16년 동안 대사위험지표 변화 추이를 살펴본 결과, 모든 그룹에서 혈압의 유의미한 감소 추세를 보였다 (p < 0.001). 소득이 가장 높은 그룹에서는 공복혈당 (p = 0.004), 총 콜레스테롤 (p < 0.001), LDL-콜레스테롤 농도 (p = 0.01)가 유의하게 감소하는 추이를 보였고, HDL-콜레스테롤 농도 (p < 0.001)는 유의하게 증가하는 추이를 보였다. 저소득층에서는 공복혈당 (p = 0.02), 총 콜레스테롤 (p < 0.001), 중성지방 농도 (p = 0.003)가 시간 경과에 따라 유의적으로 감소하는 경향을 보였다. 그러나 중간소득층에서는 혈압을 제외한 모든 대사 위험 인자에 유의적인 변화 추이가 발견되지 않았다. 결론적으로 당뇨병 환자의 소득수준에 따른 대사 위험 인자의 관리수준에는 차이가 없었다. 최근 16년의 관찰 기간 동안 소득이 가장 높은 그룹과 가장 낮은 그룹은 대사 위험 인자의 유의미한 개선 추이를 보였으나, 중간소득 그룹은 변화가 관찰되지 않았다. 본 연구는 당뇨병 환자들의 지표 관리에 대한 전략 마련과 효과적인 보건대책을 위한 기초자료로서 중요한 의미가 있다고 사료된다.

• Nutrition Research and Practice
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• 제9권6호
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• pp.658-666
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• 2015

BACKGROUND/OBJECTIVES: The current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years. SUBJECTS/METHODS: Data were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician's diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ${\geq}126mg/dl$. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design. RESULTS: Among all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased. CONCLUSIONS: Analysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.

• 한국식생활문화학회지
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• 제25권2호
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• pp.109-116
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• 2010

Ramyen and Korean noodles (guksu) are popular foods in Korea and around the world. Since 1998, rice consumption in Korea has gradually decreased, whereas consumption of noodles has continuously increased. The purpose of this study is to assess the consumption of ramyen and Korean noodles of Koreans, using data from the Korean National Health and Nutrition Examination Survey (KNHANES) of 2007. Korean adults (>20) were selected to examine the associations between noodle consumption and food and nutrient intake and health status. SAS 9.1 and SUDAAN 9.1 were used for the data analysis. 10.3% of Korean adults consumed ramyen, and 15.4% consumed Korean noodles. The consumption of ramyen and Korean noodles were higher in men than in women, in lunch than in other meals, and in the lowest income quartile than the highest quartile. Ramyen and Korean noodle consumer groups consumed more grain products, seasonings, and oils than the nonconsumer group. The noodle group showed significantly lower systolic blood pressure than the non-consumer group. The noodle groups showed lower rates of hypertension and metabolic syndrome than the non-consumer group. From these results, we conclude that ramyen and Korean noodles may have positive health effects. More studies on the association between noodles and the health of Koreans and those in other countries should be done in the future.